A study of Thulium "RevoLix" laser usage for surgery to remove the tonsils

ISRCTN ISRCTN16280803
DOI https://doi.org/10.1186/ISRCTN16280803
Submission date
23/03/2020
Registration date
25/03/2020
Last edited
09/01/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Recurrent or chronic inflammation of the tonsils (tonsillitis) is currently a global public health issue which can severely impair an individual’s quality of life.
Tonsillectomy is a 3000-year-old operation. Tonsillectomy is a surgical procedure to remove the tonsils. Tonsils are two small glands located in the back of your throat. Although tonsillectomy is performed less often than it once was, it is still among the most common surgical procedures performed in children anywhere in the world. The main indication of tonsillectomy is the recurrent throat infection. Tonsillitis and the need for tonsillectomies are more common in children than adults. However, people of any age can experience trouble with their tonsils and require surgery.
There are several different ways to remove tonsils. Most common method is called “cold knife (steel) dissection.” In this case, your surgeon removes your tonsils with a scalpel. Another common method for tonsillectomy involves burning away the tissues through a process called cauterization, CO2 laser etc. However, like with other surgeries, there are some risks with this procedure: swelling, intraoperational and postoperational bleeding, postoperational pain and delayed healing. Tonsillectomy with Thulium RevoLix laser usage could minimize the listed risks and thus improve the patient’s quality of life after tonsillectomy surgery, as it is surgical laser available for soft tissue surgery which unifies all advantageous properties of existing laser principles in a single unit.

Who can participate?
Adults over 18 years with chronic or recurrent tonsillitis

What does the study involve?
Patients due to have tonsils removed surgically will have the right side tonsils removed using the Thilium RevoLix laser and the left side with the cold steel method. Patients will be followed up for 10 days to assess the difference between the two methods.

What are the possible benefits and risks of participating?
Improved quality of life: Having the tonsils removed, as an adult, can help prevent a recurring sore throat, or tonsillitis (inflammation of the tonsils), that may force you to miss work. By having the tonsils removed, patients should no longer experience uncomfortable symptoms, such as pain and a sore throat related to tonsillitis
Fewer infections: As the tonsils will be removed and general health improved, those who experience tonsillitis caused by bacteria should have fewer infections.
Less use of medication: If patients have fewer tonsillitis infections, they may be prescribed less medication, such as antibiotics. Although antibiotics have many benefits, they kill off good bacteria as well as the bad.
There is no specific risk of operation regarding the technique of the operation. There are standard risks of operation tonsillectomy:
Reactions to anesthetics. Swelling, bleeding during surgery, bleeding during healing, infection.

Where is the study run from?
"Heratsi" #1 Hospital complex (Armenia)

When is the study starting and how long is it expected to run for?
May 2020 to November 2020 (updated 10/07/2020, previously: June 2020)

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Prof. Anna Poghosyan (scientific)
anna.yu.poghosyan@gmail.com
Dr Manana Baghdasaryan (scientific)
m.baghdasaryan@yahoo.com
Dr Gurgen Mkhitaryan (scientific)
Mkhitaryan_GK@yahoo.com
Dr Vahe Vermishyan (public)
vahevermishyan@gmail.com
Dr Martin Misakyan (scientific)
misakyan86@inbox.ru

Contact information

Prof Anna Poghosyan
Scientific

Yerevan State Medical University
2 Koryun str.
Yerevan
0001
Armenia

ORCiD logoORCID ID 0000-0002-5116-5644
Phone +374 91474169
Email anna.yu.poghosyan@gmail.com
Dr Manana Baghdasaryan
Scientific

Yerevan State Medical University
2 Koryun str.
Yerevan
0001
Armenia

ORCiD logoORCID ID 0000-0003-1859-6685
Phone +374 91560125
Email m.baghdasaryan@yahoo.com
Dr Gurgen Mkhitaryan
Scientific

Yerevan State Medical University
2 Koryun str.
Yerevan
0014
Armenia

ORCiD logoORCID ID 0000-0002-8616-1133
Phone +374 77300180
Email Mkhitaryan_GK@yahoo.com
Dr Vahe Vermishyan
Public

Yerevan State Medical University
2 Koryun str.
Yerevan
0050
Armenia

ORCiD logoORCID ID 0000-0002-1745-4899
Phone +374 94661165
Email vahevermishyan@gmail.com
Dr Martin Misakyan
Scientific

Yerevan State Medical University
2 Koryun str.
Yerevan
0018
Armenia

ORCiD logoORCID ID 0000-0001-9151-6181
Phone +374 96044054
Email misakyan86@inbox.ru

Study information

Study designInterventional non-randomized pilot study
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeQuality of life
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleA pilot study of Thulium RevoLix laser usage for tonsillectomy
Study hypothesisThe usage of Thulium laser for tonsillectomy could minimise intraoperational and postoperational hemorrhage, postoperational pain and swallowing difficulties, wound recovering period, compared with cold steel tonsillectomy method.
Ethics approval(s)Approved 19/03/2020, The Ethics Committee of Yerevan State Medical University named after Mkhitar Heratsi (2 Koryun str., Yerevan, Armenia 0025; (+374)77 919111 ;ec@ysmu.am), ref: N 6-1/ 2020
ConditionRecurrent or chronic tonsillitis
InterventionPatient recruitment
Informed consent signing
All necessary diagnostics examination performing (blood analysis, urine analysis, chest XR, ECG)
Anesthesiologists examination
The right side tonsillectomy of all patients is performed with Thulium Revolix laser and the left side with cold steel tonsillectomy method
Hospital stay 2-4 days
Outpatient follow-up 12 days
End of participation from 13th postop day
Intervention typeProcedure/Surgery
Primary outcome measurePostoperative wound healing measured by assessment of wound surface recovery in post-operational period to 12th post-operational day
Secondary outcome measures1. Intraoperative blood loss quantified by measuring suction bottle fluid and weight measurement of surgical sponges
2. Time taken for surgery will be measured from the beginning and finishing of each side tonsillectomy
3. Postoperative pain will be measured by a numerical rating scale from 0-10 at 2, 5, 7 and 10 post-operational days
4. Postoperative bleeding will be assessed by the effectiveness of management strategy (no therapy, clot suction, direct pressure or electrocautery) at 2, 5, 7 and 10 post-operational days
5. Time taken for complete healing measured by comparing both tonsillectomy sides by serial direct clinical examinations at 2, 5, 7 and 10 post-operational days
Overall study start date03/02/2020
Overall study end date01/11/2020

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants12
Participant inclusion criteria1. Chronic or recurrent tonsillitis
2. Age over 18 years
Participant exclusion criteria1. Bleeding diathesis
2. Poor anesthetic risk
3. Uncontrolled medical illness
4. Anemia
5. Acute infection
Recruitment start date01/05/2020
Recruitment end date01/06/2020

Locations

Countries of recruitment

  • Armenia

Study participating centre

"Heratsi" #1 Hospital Complex
Yerevan State Medical University
60 Abovyan str.
Yerevan
0025
Armenia

Sponsor information

Yerevan State Medical University
Hospital/treatment centre

"Heratsi" #1 Hospital complex
60 Abovyan str.
Yerevan
0025
Armenia

Phone +374 (11) 621098
Email mfs.ent.dep@gmail.com
Website http://www.hcplasticsurgery.com
ROR logo "ROR" https://ror.org/01vkzj587

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/06/2022
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planPublication and dissemination of trial results are planned for June 2022. The researchers are intending to publish the results of the pilot study of comparative assessment of Thulium Revolix Laser usage for tonsillectomy in comparison with cold steel dissection with bipolar electrocautery.
IPD sharing planAll data generated or analysed during this study will be included in the subsequent results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Preprint results non-peer-reviewed results in preprint 04/01/2023 09/01/2023 No No

Editorial Notes

09/01/2023: Preprint (non-peer-reviewed) publication added.
04/04/2022: The intention to publish date was changed from 01/04/2022 to 01/06/2022.
17/01/2022: The following changes have been made:
1. The intention to publish date has been changed from 03/01/2022 to 01/04/2022.
2. The publication and dissemination plan has been updated.
09/11/2021: The intention to publish date was changed from 01/11/2021 to 03/01/2022.
10/07/2020: The following changes were made to the trial record:
1. The overall end date was changed from 01/10/2020 to 01/11/2020.
2. The intention to publish date was changed from 01/11/2020 to 01/11/2021.
3. The plain English summary was updated to reflect these changes.
24/03/2020: Trial’s existence confirmed by Yerevan State Medical University.